NPI | 1710368105 |
---|---|
Former Name | LAUREN STORBAKKEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R1136) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10054658) |
Enumeration Date | 2015-06-11 |
Last Update Date | 2024-11-11 |